Philip Niles — Billing Profile & Reimbursement Data
NPI 1609136126 · Williamsville, NY · Retina Specialist (Ophthalmology) Physician
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Philip Niles is a retina specialist (ophthalmology) physician provider located in Williamsville, New York. This profile covers 14 Medicare and 5 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Philip Niles |
| Address | 6480 Main St |
| City | Williamsville |
| State | NY |
| ZIP | 14221 |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| NPI Enumerated | May 17, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.6M |
| Medicaid | $21.1K |
Medicare: Total Revenue Breakdown by CPT/HCPCS Code
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
Medicare: Complete Services Breakdown
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | 1,210 | $690 | $838.7K |
| J2777 | Injection, faricimab‑svoa, 0.1 mg | 11,820 | $30 | $342.8K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 1,250 | $100 | $122.7K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 1,210 | $60 | $72.5K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 560 | $90 | $50.1K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 1,530 | $30 | $43K |
| J2778 | Injection, ranibizumab, 0.1 mg | 210 | $180 | $37.3K |
| J9035 | Injection, bevacizumab, 10 mg | 680 | $50 | $36.9K |
| 92250 | Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,… | 300 | $30 | $7.7K |
| 92235 | The provider uses a special dye, fluorescein that causes the blood vessels in the one or both eyes to stand out in photographic images taken with the use of multiframe timing, or serial images, taken… | 50 | $100 | $4.8K |
Showing 1–10 of 14
Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0178 | 70 | 230 | 560 | $690 | $693K |
| J2777 | 36 | 120 | 7,740 | $30 | $364.9K |
| J2778 | 64 | 70 | 510 | $180 | $131.6K |
| 67028 | 51 | 300 | 400 | $100 | $65.9K |
| 92014 | 377 | 2,220 | 160 | $100 | $29.3K |
| 92012 | 47 | 1,640 | 100 | $70 | $17.4K |
| 92235 | 106 | 190 | 60 | $120 | $14.1K |
| 92134 | 93 | 1,580 | 90 | $30 | $11.2K |
| J9035 | 4 | 190 | 120 | $50 | $10K |
| 92004 | 954 | 1,750 | 50 | $110 | $9.2K |
Showing 1–10 of 14
Medicaid: Total Revenue Breakdown by CPT/HCPCS Code
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Medicaid: Complete Services Breakdown
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 280 | $30 | $9.1K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 320 | $10 | $4.2K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 250 | $20 | $3.8K |
| J9035 | Injection, bevacizumab, 10 mg | 200 | $20 | $2.9K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 60 | $20 | $1.3K |
Medicaid: Competitive Analysis & Benchmarks
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 1,862 | 2,440 | 330 | $70 | $92.6K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 778 | 1,460 | 310 | $60 | $88.1K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 156 | 260 | 420 | $70 | $65.6K |
| J9035 | Injection, bevacizumab, 10 mg | 69 | 150 | 170 | $80 | $36.7K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 389 | 730 | 370 | $20 | $30K |
Nearby Providers
Other providers in the same ZIP code as Philip Niles, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Willcare, Inc. | NY | Home Health Agency | $0 | $60.6M |
| America Homecare Inc | NY | In Home Supportive Care Agency | $0 | $40.4M |
| Buffalo Emergency Associates LLP | NY | Emergency Medicine Physician | $0 | $24M |
| Martin Boscarino | NY | Ophthalmology Physician | $1.5M | $27.9K |
| Endoscopy Center Of Western New York LLC | NY | Ambulatory Surgical Clinic/Center | $462.5K | $964K |
| Wehrle Drive Asc LLC | NY | Ambulatory Surgical Clinic/Center | $967.1K | $0 |
| Christopher Jermak | NY | Ophthalmology Physician | $902.1K | $27K |
| Ramakrishna Ratnakaram | NY | Ophthalmology Physician | $723.2K | $12.7K |
| Paul Wirth | NY | MOHS-Micrographic Surgery Physician | $611.2K | $1.4K |
| Andrew Dunn | NY | Diagnostic Radiology Physician | $596.3K | $6.4K |
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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